Multiday rhythms modulate human heart rate: an observational study in healthy adults

Abstract Background Chronobiology research has historically focused on circadian rhythms; however, longer infradian rhythms are prevalent in human physiology and may have important implications for health and wellbeing. Previous studies have identified widespread infradian rhythms across human physiology, often in the context of hormonal regulation and disease. Despite growing evidence of their ubiquity, the mechanisms, significance, and clinical relevance of these rhythms remain poorly understood, largely due to lack of longitudinal datasets and robust detection methods. The emergence of new wearable technologies enables rich, continuous data capture within individuals, allowing physiological rhythms to be studied at scale. Methods This study analyzed a cohort of healthy, young adults (N=623), with up to four years of wearable and questionnaire data collected through the University of Notre Dame’s (USA) NetHealth project. Participants who recorded at least three months of continuous (>80% adherence) heart rate data were included and significant infradian rhythms were identified using wavelet analysis. Unsupervised non-negative matrix factorization was performed to cluster similar wavelet power spectrum distributions. Individuals’ heart rate rhythms were compared to known environmental cycles (day-of-week, lunar, seasonal) and considering demographics and social networks. A second, smaller cohort (N=70) with heart rate and menstrual timing were included to analyze the interplay of hormonal regulation on monthly cycles. Multinomial logistic regression, and statistical tests (i.e., one-way ANOVA) were applied to quantify the effects of environmental, behavioral and demographic factors on heart rate rhythms. Findings Significant infradian rhythms of heart rate were detected in 69.7% (365/523) of the cohort and 35.9% (188/523) had two or more rhythms. Annual, biannual and 10-week rhythms were the most common. Within the 4–45-day band, individuals clustered into four multiday chronotypes based on dominant periodicities in their wavelet power spectra: weekly (∼7 days), shorter-monthly (∼25 days), longer-monthly (∼35 days), and multi-month (>35 days). Heart rate rhythms were influenced by environmental cycles (day-of-week and seasonality) but were not tightly correlated to external cues. Additionally, heart rate rhythms were synchronized to the menstrual cycle in most menstruating females, although monthly rhythms were also observed in males and menopausal women. Interpretation The prevalence of infradian, or multiday heart rate rhythms in healthy young people motivates further scientific investigation to understand the mechanisms of these rhythms and their potential association with autonomic function, and risk of disease or disease-specific symptoms. Characterizing physiological rhythms can drive new insights into how multiscale fluctuations modulate disease symptoms across neurological, psychiatric, and broader health conditions.